MSHO frequently asked questions

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What services can I get through MSHO?

MSHO offers the same services as Medical Assistance and Medicare:

  • • doctor visits
  • • emergency room care
  • • hospitalization
  • • dental care
  • • lab and X-rays
  • • durable medical equipment
  • • prescription drugs
  • • personal care attendant services
  • • home health services
  • • home and community-based services (Elderly Waiver)
  • • nursing home care
  • • transportation
  • • interpreter services
  • • a care coordinator.
  • An MSHO health plan may offer additional services.

    What does the care coordinator do?

    Once you have enrolled in MSHO, you are assigned a care coordinator. The care coordinator will help answer your questions, work with your doctors to help you get the care you need, and help your doctors and other providers share information with each other. If you had a county case manager for home and community-based services before enrolling in MSHO, in most cases, the care coordinator will replace the case manager.

    How much will MSHO cost me? What if I have a spenddown or a waiver obligation?

    MSHO is a free health care program. If you have a Medical Assistance spenddown (PDF), you will receive a letter from the Minnesota Department of Human Services telling you how to pay these amounts. If you have a waiver obligation and you enroll in MSHO, your health care provider will bill you for your waiver obligation.

    I am over 65, on Medical Assistance and Medicare, and I am enrolled in a health plan. How is MSHO different from what I have now?

    MSHO offers the same basic benefits as Medicare and Medical Assistance but with MSHO you don’t have to go to a lot of different offices for your health care needs or fill out a lot of paperwork. All of these services are combined into one program. Under MSHO, your health plan is responsible for making sure you get the health care, and home and community-based services you need. Your health plan will also handle most of the paperwork for Medical Assistance and Medicare.

    Additionally, through an MSHO health plan, you will be assigned a care coordinator. A care coordinator is someone who can help answer your questions and who will help you get the health care and other related services you need. The care coordinator will also make sure all of your providers such as your primary care doctor, physical therapist, home care and hospital staff, are in contact with each other.

    Will I be able to keep seeing my regular doctor?

    If you want to keep seeing your regular doctor, review the names of the doctors that are part of the MSHO health plan network. You can sign up for the MSHO health plan in which your doctor participates. If your doctor is not listed with any of the MSHO health plans and you want to keep seeing that doctor, then you may not want to enroll in MSHO.

    Can I enroll in MSHO if I am in a nursing home?

    Yes, if you are in a nursing home you may enroll in MSHO. You may be assigned a nurse practitioner who will serve as your coordinator for primary care and other services. The nurse practitioner works with your doctor, nursing home and other health plan staff.

    What if I join MSHO and decide I don’t like it?

    You can drop MSHO at any time. To do that, you must write a letter to your MSHO health plan telling them than you want to drop the program. You will be taken out of MSHO program at the beginning of the next month.

    Who runs the MSHO program?

    MSHO is a health care program created by DHS, the state agency that oversees public health care programs. The MHSO program is overseen by DHS, the federal Centers for Medicare & Medicaid and administered by health plans.

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